Tutoring Application
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Email *
Parent Name *
First Name *
Last Name *
Gender *
Birthday *
MM
/
DD
/
YYYY
City *
State *
Zip *
Phone Number *
E-mail *
What school does your child attend? *
What grade? *
Subject Student needs help *
Example: English, Math, etc.
Tutoring location *
Do you consent to your child's photograph being taken? *
Does the student receive free/reduced school lunch? *
Does the student take any medication? *
Does the student have any medical condition? *
List the student's medical condition.
Does the student have any food allergies? *
What food allergies does your child have?
Transportation/Registration/Membership
Hope Community Resource Center (HCRC) does not offer transportation, and parents are responsible for dropping off and picking up students for our location. Registration & Membership fee $50.00
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